Written Answers Nos. 426-443
426. Deputy Marc MacSharry asked the Minister for Health when paediatric physiotherapy services will be made available to a child (details supplied) in County Donegal; and if he will make a statement on the matter. [5511/19]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
427. Deputy Jackie Cahill asked the Minister for Health if a full review of the medical needs of a person (details supplied) will be carried out; and if he will make a statement on the matter. [5523/19]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
428. Deputy Louise O'Reilly asked the Minister for Health if all Travellers will be provided with a medical card in view of the perceived level of Traveller health inequalities that exist; and if he will make a statement on the matter. [5524/19]
Amharc ar fhreagraUnder the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family can qualify for full eligibility (a medical card). The HSE can only award medical cards in accordance with the Health Act and, therefore, it must assess applicants on the overall financial situation of the applicant and his or her spouse or partner.
The HSE is obliged to operate within the legal parameters as set out in the Health Act, while also responding to the variety of circumstances and complexities faced by individuals who apply for a medical card. Under the legislation, there has never been an entitlement to a medical card based on having a particular disease or illness. The HSE gives effect to this legislation through its Medical Card National Assessment Guidelines.
The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.
Nevertheless, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment including medical evidence of cost and necessary expenses.
The HSE also has a system in place for the provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill.
429. Deputy Louise O'Reilly asked the Minister for Health the number of persons treated for gambling addiction in each of the years from 2007 to 2018; and if he will make a statement on the matter. [5525/19]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
430. Deputy Louise O'Reilly asked the Minister for Health if a dedicated nationwide gambling prevalence survey will be undertaken to identify the number of problem gamblers here, ascertain the scale of problem gambling and put the correct supports in place; and if he will make a statement on the matter. [5526/19]
Amharc ar fhreagraThe Drug Use in Ireland and Northern Ireland, Drugs Prevalence Survey 2014/2015 contains data on prevalence rates on gambling. A section on gambling was included in this survey for the first time at the request of the Department of Justice and Equality. This prevalence survey is a general population survey and is intended to reflect drug use and gambling in the general population. For the purposes of this survey, the general population is taken to mean those aged 15+ and normally residing in households in Ireland and Northern Ireland. It does not include those residing in institutions such as prisons, residential care, nursing homes, hospitals etc.
The results from the survey are published on the Department of Health website www.health.gov.ie. This showed prevalence rates for gambling of 64.4% in the last year and of 40.7% in the last month.
A detailed analysis of gambling prevalence has been completed and will be published as a separate bulletin in the near future. This will provide information on the common forms of gambling, the proportion spending over €250 per annum on gambling, the prevalence of gambling by age, gender and socio-economic group, and the extent of problem gambling.
The Health Research Board is currently administering the drugs prevalence survey for 2018/2019 on behalf of the Department of Health. This survey will again contain data on gambling prevalence, with an extended range of questions.
Responsibility for government policy on gambling lies with the Department of Justice and Equality. A review of government policy is being undertaken by my colleague, David Stanton T.D., Minister of State for Equality, Immigration and Integration at the Department of Justice and Equality. It is important that the prevalence of gambling, especially problem gambling, is monitored by Government. I look forward to sharing the results with Minister Stanton and other interested parties.
431. Deputy Róisín Shortall asked the Minister for Health the number of whole-time equivalent posts employed by the Health Service Executive in the child and adolescent mental health services, CAMHS, in north and south County Tipperary; the number of whole-time equivalent vacancies in County Tipperary CAMHS; and if he will make a statement on the matter. [5527/19]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
432. Deputy Róisín Shortall asked the Minister for Health the position regarding a facility (details supplied); the number of beds in the service; if the HSE plans to close the service; if so, the service which will replace it; and if he will make a statement on the matter. [5528/19]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
433. Deputy Róisín Shortall asked the Minister for Health his plans to improve and expand CAMHS in County Tipperary in view of the need for service improvement; and if he will make a statement on the matter. [5529/19]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
434. Deputy Charlie McConalogue asked the Minister for Health the status of the provision of the drug Savitex; when he expects the assessment to be finalised; and if he will make a statement on the matter. [5538/19]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the pricing and reimbursement of medicines; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
435. Deputy Clare Daly asked the Minister for Health if the Health Products Regulatory Authority's equivalent of black box warnings apply to morcellators sold here. [5542/19]
Amharc ar fhreagraMedical devices placed on the Irish or European market must conform to the requirements of the relevant European legislation. These require that medical devices perform safely while achieving the purpose intended by the medical device manufacturer. The risk classification of a device influences the level of specific assessment of a medical device’s conformity with the legal requirements that is conducted and in the case of morcellators, a manufacturer must have the conformity to the requirements verified by a third party, namely a notified body for medical devices.
Once the notified body has satisfactorily completed its assessment it issues a certificate to the manufacturer who can then label their device with a CE mark. Medical devices which are appropriately CE marked may be freely placed on the European market. A notified body, once appropriately competent, in any European country can issue a certificate which allows the manufacturer to place the device on the market without further national authorisation.
Officials in my Department have queried this matter with the Health Products Regulatory Authority (HPRA), who understand that the black box warning referenced to in this question relates to a FDA warning issued in April 2014 that discouraged the use of laparoscopic power morcellation during hysterectomy or myomectomy for uterine fibroids and advised that such use poses a risk of spreading unsuspected cancerous tissue, notably uterine sarcomas, beyond the uterus. Subsequently, following a public Advisory Committee meeting, the FDA also recommended that manufacturers of laparoscopic powered morcellators with a general indication or a specific gynaecologic indication prominently include a number of contraindications and a boxed warning in their product labelling.
In May 2014 the HPRA (then the Irish Medicines Board) wrote to Consultant Obstetricians and Gynaecologists via their professional associations (Royal College of Physicians in Ireland and Royal College of Surgeons in Ireland) highlighting the April 2014 FDA communication and requesting feedback on the information outlined in the FDA communication. The HPRA also coordinated with the European Commission and other European Competent Authorities to issue a letter to all medical device notified bodies in Europe highlighting that the FDA had requested that manufacturers of these products include contraindications and warnings on their product instructions and labelling. Notified bodies were requested to consider this potential risk in their review of manufacturers’ technical documentation and any updated product information, including labelling and instructions for use. Please note that within the context of the HPRA's role as designating authority for the National Standards Authority of Ireland (NSAI), HPRA communicated this issue to NSAI in November 2015.
436. Deputy Clare Daly asked the Minister for Health the number of women here who have died in the past decade within a year of having hysterectomies by morcellation. [5543/19]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible
437. Deputy Thomas Byrne asked the Minister for Health the position regarding the proposed name change of Our Lady of Lourdes Hospital, Drogheda; and if he will make a statement on the matter. [5547/19]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly.
438. Deputy Timmy Dooley asked the Minister for Health when a child (details supplied) in County Clare will have an assessment and ultrasound in the urology department of University Hospital Limerick; and if he will make a statement on the matter. [5564/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
439. Deputy Martin Ferris asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [5566/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
440. Deputy Denis Naughten asked the Minister for Health his plans to address a waiting list for autism services (details supplied); his plans to appoint additional staff to the service; his plans for budget increases for the services; the alternatives available for those awaiting the service; and if he will make a statement on the matter. [5574/19]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
441. Deputy Mattie McGrath asked the Minister for Health if measures are in place to provide for a statutory declaration by consultants, clinicians and other medical practitioners who receive gifts or donations from pharmaceutical and other companies involved in the healthcare sector; and if he will make a statement on the matter. [5582/19]
Amharc ar fhreagraUnder the Ethics in Public Office Acts, positions in the Health Service Executive across all grade categories and work streams where the minimum salary point is equal to or above the minimum point of Grade VIII, including medical doctors, must provide a disclosure of interest, which could influence them in the performance of their official duties. The Standards in Public Office Commission (SIPO) publishes guidelines to ensure compliance with the legislation.
The Irish Pharmacy Healthcare Association (IPHA) has a Code of Practice in place which requires all IPHA member companies to disclose payments, collaborations and other transfers of values made to healthcare professionals and healthcare organisations. Disclosable activities include medical conferences; clinical trials and research and patient education and awareness initiatives, as well as specific interactions such as research and medical grants. While full disclosure is given in relation to healthcare organisations, disclosure of interactions with individual healthcare professionals requires consent. Consent is encouraged but in its absence an aggregate figure for an unnamed professional is published.
Regulation of medical doctors is undertaken by the Medical Council. The Medical Council has a guide published in 2016, the Guide to Professional Conduct and Ethics for Registered Medical Practitioners. While the Guide is not a legal code, it sets out the principles of professional practice and conduct that all medical doctors registered with the Medical Council are expected to follow. The Guide advises that doctors 'should not accept gifts (including hospitality) from pharmaceutical, medical devices or other commercial enterprises'. In May 2018 the Medical Council issued updated guidance for registered medical practitioners on relationships between doctors and industry which covers a number of issues such as gifts, sponsorship and hospitality.
442. Deputy John Curran asked the Minister for Health the additional funding allocated to the HSE to reduce the waiting lists and waiting times for home support services; and if he will make a statement on the matter. [5585/19]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
443. Deputy John Curran asked the Minister for Health the number of children waiting for an outpatient appointment in children’s hospitals in Dublin (details supplied) for more than 18 months; and if he will make a statement on the matter. [5586/19]
Amharc ar fhreagraI am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, I am committed to improving waiting times for hospital appointments and procedures.
I hope to publish the joint Department of Health, Health Service Executive (HSE) and National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 shortly. This will set out commitments aimed at improving access for patients waiting for hospital operations or procedures, as well as patients waiting for a first Outpatient appointment.
As of the end of December 2018, there were 45,595 patients awaiting an outpatient appointment for the Children's Hospital Group. Of these 51% (23,492) were waiting less than 9 months, while 25% (11,288) were waiting more than 18 months.
A key element of the 2019 Access Plan is the stabilisation of the Outpatient Waiting List which remains a significant challenge. The HSE, in line with the National Service Plan 2019 will provide 3.3 million outpatient appointments, more than 1 million of which will be first outpatient appointments.
In 2019, the HSE will focus in particular on specialties with a high volume of referrals and large proportions of long-waiting patients including ENT and Dermatology. In addition, the NTPF, with an increased allocation totalling €75 million in 2019, will fund an additional 40,000 first outpatient appointments through weekend and out of hour’s clinics and ‘see and treat’ clinics.
The NTPF will deliver this additional activity in the health service by working with hospital groups and individual hospitals as well as private health providers to maximise the number of patients treated in both a public and private capacity. In this context, in 2018 the NTPF approved 504 Outpatient appointments for Temple Street as part of an initiative to support implementation of an extended working day in the hospital. The NTPF have also met with Children’s Health Ireland (CHI) to review Outpatient proposals covering the specialties of Cardiology, Ophthalmology, and Dental Surgery.
CHI advises that it has implemented a number of new and innovative initiatives to improve access to outpatient appointments for patients across a range of specialties including cardiology, dermatology, and orthopaedics. This includes additional clinics in ENT and dermatology, the appointment of additional staff in general paediatrics and ophthalmology, and the use of virtual assessment clinics for rheumatology.
In addition, the establishment of the Outpatient and Urgent Care Centre at Connolly Hospital in 2019 will result in 6,350 outpatient appointments being issued for the new facility next year, with projected full year outpatient attendance of 15,240 in subsequent years.
